customer testimonial release form

Media Consent and Testimonial Release Agreement

Instructions for Use

• Fill in all bracketed information accurately, ensuring the person signing has the legal authority to grant these rights on behalf of themselves or their organization.
• Retain a fully executed copy of this document in your internal compliance files for as long as the testimonial or media is being used in public-facing materials.
• If the subject of the testimonial is a minor, ensure the signature block is completed by a parent or legal guardian.

Parties and Definitions

This Agreement is entered into by and between [Company Name], located at [Company Address] ("Company"), and [Full Legal Name of Participant], located at [Participant Address] ("Participant"). The "Content" refers to any statements, quotes, photographs, video recordings, audio recordings, or other media provided by the Participant to the Company.

Operative Terms

1. Grant of Rights. Participant hereby grants to the Company, its successors, and assigns, a perpetual, irrevocable, worldwide, royalty-free, and non-exclusive license to use, reproduce, distribute, display, and create derivative works from the Content in any media now known or hereafter developed, including but not limited to websites, social media, marketing collateral, and advertising.

2. Right of Publicity. Participant grants the Company the right to use the Participant's name, likeness, professional title, and company affiliation in connection with the use of the Content.

3. Waiver of Review. Participant acknowledges that they have no right to inspect or approve the finished product, the advertising copy, or the printed matter that may be used in connection with the Content. Participant waives any right to royalties or other compensation arising from or related to the use of the Content.

4. Representations and Warranties. Participant warrants that they are the sole owner of the Content, that they have the full right and authority to enter into this Agreement, and that the Content does not infringe upon the rights of any third party or contain any defamatory material.

5. Release of Liability. Participant hereby releases and discharges the Company from any and all claims, demands, or causes of action that Participant may now have or may hereafter have arising out of or in connection with the use of the Content, including claims for libel, defamation, invasion of privacy, or right of publicity.

6. Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the state of [State Name], without regard to its conflict of law principles.

Signature and Acknowledgment

By signing below, the Participant acknowledges they have read this document in its entirety, understand its legal implications, and voluntarily agree to its terms.

Signature: __________ Printed Name: [Full Legal Name] Title: [Job Title, if applicable] Date: [Date]

Legal Disclaimer: This document is a general framework and does not constitute legal advice. Laws regarding media releases and privacy vary by jurisdiction. You should consult with qualified legal counsel to ensure this document complies with local, state, and federal requirements.